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BMC International Health and Human Rights
Published in: BMC International Health and Human Rights 1/2012

Open Access 01-12-2012 | Research article

Sensory functions in the foot soles in victims of generalized torture, in victims also beaten under the feet (falanga) and in healthy controls – A blinded study using quantitative sensory testing

Authors: Karen Prip, Ann L Persson, Bengt H Sjölund

Published in: BMC International Health and Human Rights | Issue 1/2012

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Abstract

Background

Falanga torture (beatings on the foot soles) produces local chronic pain and severe walking difficulties. We have previously reported signs of neuropathic pain in the feet of falanga victims. The objective here was to clarify underlying pain mechanisms by quantifying sensory impairments in the feet of torture victims who had experienced both generalized torture and those who had been exposed to falanga in addition. An ethnically matched control group was available.

Methods

We employed quantitative sensory testing (QST) by investigators blinded to whether the patients, 32 male torture victims from the Middle East, had (n=15), or had not (n=17) been exposed to falanga. Pain intensity, area and stimulus dependence were used to characterize the pain as were interview data on sensory symptoms. QST included thresholds for touch, cold, warmth, cold-pain, heat-pain, deep pressure pain and wind-up to cutaneous noxious stimuli in the foot soles. Clinical data on anxiety and depression were retrieved.

Results

Almost all falanga victims had moderate or strong pain in their feet and in twice as large an area of their foot soles as other torture victims. One-third of the latter had no pain in their feet and many reported slight pain; in spite of this, there were no differences in foot sole QST data between the tortured groups. A comparison with normal data indicated that both tortured groups had hypoesthesia for all cutaneous sensory fibre groups except those transmitting cold and heat pain, in addition to deep mechano-nociceptive hyperalgesia.

Conclusion

A comparison of the QST data between victims having been exposed to generalized torture and victims who in addition had been exposed to falanga, showed no differences on the group level. The sensory disturbances in relation to our control group are compatible with central sensitization and de-sensitization, pointing to a core role of central mechanisms. A further analysis to create individual sensory profiles from our measurements is in progress.
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Prip K, Persson AL, Sjölund BH: Pain when walking: individual sensory profiles in the foot soles of torture victims. A controlled study using quantitative sensory testing. BMC Int Health Hum Rights. 2012, 12: 40-10.1186/1472-698X-12-40.CrossRefPubMedPubMedCentral
Metadata
Title
Sensory functions in the foot soles in victims of generalized torture, in victims also beaten under the feet (falanga) and in healthy controls – A blinded study using quantitative sensory testing
Authors
Karen Prip
Ann L Persson
Bengt H Sjölund
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC International Health and Human Rights / Issue 1/2012
Electronic ISSN: 1472-698X
DOI
https://doi.org/10.1186/1472-698X-12-39

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